The Provider Portal is a secure online resource for healthcare providers’
practices or offices to use when requesting benefit verifications. It offers
a quick and easy way to enroll patients and maintain insurance verification
status updates accessible through the website
www.DALVANCECONNECTS.com.

The Portal Provides:

A convenient way for registered HCPs to enroll a patient online or check the
patient’s status

Access to real-time information about the patient’s enrollment status that can
be accessed according to the schedule of the user, along with reports and lists
that can be tailored to the user’s needs

Unsecured services available at all times without having to register will include key
Forms and Resources on coverage, coding, and payment that support the access for DALVANCE
(dalbavancin) for injection.

Financial assistance for patients

The DALVANCE CONNECTS℠ Co-Pay Assistance Program
may provide eligible commercial insurance patients assistance with their
out-of-pocket costs for DALVANCE.

Eligible patients with an out-of-pocket cost for DALVANCE of greater than
$50 per infusion may qualify to receive assistance after the patient has
paid the first $50 per infusion, when administered at any outpatient
setting of care,* whether it is for the 1 dose infusion (1500 mg) or the
first (1000 mg) or second (500 mg) IV infusion of the 2 dose regimen of
DALVANCE

The program will provide a maximum of $800 in assistance over 1 or 2
infusions of DALVANCE within a 12-month period

Includes a practice-based or freestanding infusion center, hospital outpatient
department, or home infusion service.

Here’s Who Is Eligible†

Any patient who:

Is 18 years of age or older and has commercial insurance

Is a resident of, and is treated with DALVANCE in, the US (including Puerto
Rico, US Virgin Islands, and Guam)

Is administered DALVANCE in an outpatient setting of care

This is not insurance. Subject to change or discontinuation by Allergan at any time.

Reimbursement Specialist

For assistance with the reimbursement process—prior
authorizations, benefit verification, coverage, coding, and
payment for DALVANCE—get help from a reimbursement
specialist.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of DALVANCE and other antibacterial
agents, DALVANCE should be used only to treat infections that are proven or strongly suspected to be caused by susceptible
bacteria.

IMPORTANT SAFETY INFORMATION

Contraindications

DALVANCE is contraindicated in patients with known hypersensitivity to dalbavancin.

Warnings and Precautions

Hypersensitivity Reactions

Serious hypersensitivity (anaphylactic) and skin reactions have been reported with glycopeptide antibacterial agents, including
DALVANCE. Exercise caution in patients with known hypersensitivity to glycopeptides due to the possibility of cross-sensitivity.
If an allergic reaction occurs, treatment with DALVANCE should be discontinued.

Infusion-related Reactions

Rapid intravenous infusion of DALVANCE can cause reactions, including flushing of the upper body, urticaria, pruritus, rash,
and/or back pain.

Hepatic Effects

ALT elevations with DALVANCE treatment were reported in clinical trials.

Clostridium difficile-associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) has been reported with nearly all systemic antibacterial agents, including
DALVANCE, with severity ranging from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.

Development of Drug-resistant Bacteria

Prescribing DALVANCE in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the
patient and increases the risk of the development of drug-resistant bacteria.

Adverse Reactions

The most common adverse reactions in patients treated with DALVANCE were nausea (4.7%), headache (3.8%), and diarrhea
(3.4%).

Use in Specific Populations

There have been no adequate and well-controlled studies with DALVANCE in pregnant or nursing women.
DALVANCE should only be used if the potential benefit justifies the potential risk in these populations.

In patients with renal impairment whose known creatinine clearance is less than 30 mL/min and who are not receiving
regularly scheduled hemodialysis, the recommended regimen of DALVANCE is 1125 mg, administered as a single
dose, or 750 mg followed one week later by 375 mg. No dosage adjustment is recommended for patients receiving
regularly scheduled hemodialysis, and DALVANCE can be administered without regard to the timing of hemodialysis.

Caution should be exercised when prescribing DALVANCE to patients with moderate or severe hepatic impairment
(Child-Pugh Class B or C) as no data are available to determine the appropriate dosing in these patients.

The information provided in this site is intended for US healthcare professionals only.
The products described on this site may have different product labeling in countries outside of the United States.

DALVANCE IS INDICATED
for the treatment of adult patients with acute bacterial skin and
skin structure infections (ABSSSI) due to designated susceptible
Gram-positive pathogens.
See full Indication and Usage below.

IMPORTANT SAFETY INFORMATION

Contraindications

DALVANCE is contraindicated in patients with known hypersensitivity to dalbavancin.

Show More

Warnings and Precautions

Hypersensitivity Reactions

Serious hypersensitivity (anaphylactic) and skin reactions have been reported with glycopeptide antibacterial agents, including
DALVANCE. Exercise caution in patients with known hypersensitivity to glycopeptides due to the possibility of cross-sensitivity.
If an allergic reaction occurs, treatment with DALVANCE should be discontinued.

Infusion-related Reactions

Rapid intravenous infusion of DALVANCE can cause reactions, including flushing of the upper body, urticaria, pruritus, rash,
and/or back pain.

Hepatic Effects

ALT elevations with DALVANCE treatment were reported in clinical trials.

Clostridium difficile-associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) has been reported with nearly all systemic antibacterial agents, including
DALVANCE, with severity ranging from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.

Development of Drug-resistant Bacteria

Prescribing DALVANCE in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the
patient and increases the risk of the development of drug-resistant bacteria.

Adverse Reactions

The most common adverse reactions in patients treated with DALVANCE were nausea (4.7%), headache (3.8%), and diarrhea
(3.4%).

Use in Specific Populations

There have been no adequate and well-controlled studies with DALVANCE in pregnant or nursing women.
DALVANCE should only be used if the potential benefit justifies the potential risk in these populations.

In patients with renal impairment whose known creatinine clearance is less than 30 mL/min and who are not receiving
regularly scheduled hemodialysis, the recommended regimen of DALVANCE is 1125 mg, administered as a single
dose, or 750 mg followed one week later by 375 mg. No dosage adjustment is recommended for patients receiving
regularly scheduled hemodialysis, and DALVANCE can be administered without regard to the timing of hemodialysis.

Caution should be exercised when prescribing DALVANCE to patients with moderate or severe hepatic impairment
(Child-Pugh Class B or C) as no data are available to determine the appropriate dosing in these patients.